Medical school: LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
Graduated: 2020
NPI: 1346879939
Practice Locations (2)
OHI WEST MEDICAL GROUP LLC
603 7TH ST S, SUITE 400
ST PETERSBURG, FL 337014734
7275537420
LEGACY HEALTHCARE SERVICES INC
17470 BROOKSIDE TRACE CT
TAMPA, FL 336476201
8134435042
Source: CMS National Downloadable File, September 2026.